The outcomes of rheumatoid arthritis (RA) in ethnic minority populations in the United States are relatively understudied, but are of substantial importance. Ethnic minorities constitute approximately 30% of the U.S population, and are at particular risk for poor health outcomes in part due to lower socioeconomic status. The latter includes lower levels of formal education, income, level of health insurance, and access to health care. Cultural, behavioral, and psychological factors unique to each ethnic group also have impact on health outcomes and utilization of health care resources. Physicians' attitudes toward the treatment of RA in minority groups requires more attention in the overall characterization of the pattern of health outcomes and utilization of health care resources. Physician's attitudes toward the treatment of RA in minority groups requires more attention in the overall characterization of the patterns of health care delivery. The role of genetic factors also requires ongoing study. Whether there is a role for the RA "shared epitope" in different ethnic minorities is still controversial, yet at the same time, the identification of new candidate genes and their role in disease expression serves as additional material in the investigation into RA pathogenesis. The many factors will be included in a comprehensive study of RA outcomes in minority populations in this project. Its specific aims are to compare the differences in long-term cumulative disability, pain, and patient global score outcomes in Caucasian, African-American, Hispanic, and Asian patients with RA, and to examine whether any disparity in these long-term outcomes between is related to differences in genetic substrate, gender, educational level, socioeconomic status, access to medical care, prescribed treatment, therapeutic adherence, or treating center. The resources of the ARAMIS consortium will be used to assemble patient populations for a series of comparative studies will further elucidate the contribution of sociodemographic factors and clarify the role of biologic elements. Identification of the specific needs, problems, and features of RA in minority populations may afford the opportunity to develop specific interventions, as well as social and health policies, to help reduce health disparities.